RVS Form B

(SIF B-1)
MEDICAL COUNCIL OF INDIA

STANDARD INSPECTION FORM
FORM B
On the
Facilities for teaching in the subject of
ANATOMY
For the Course of study leading up to
M.B.B.S. Examination
Name of Institution
RVS INSTITUTION OF MEDICAL SCIENCES
Place
R.V.S. Nagar, Tirupathi Road,

Puthalapattu Mandal, Chittoor,
Andhra Pradesh- 517 127.
Affiliated to the University of : DR.NTR UNIVERSITY OF HEALTH

SCIENCES,VIJAYAWADA-520008,
ANDHRA PRADESH
Name of the Head of the Department .
Signature of the Dean/Principal

(with seal)
Signature of the
Head of the Department
(This form shall be first filled in by the Principal/Dean of the college in

collaboration with the Head of the Department and handed over to the
Inspector, who shall examine the information already furnished & gather such
additional information as may be necessary to fill in the spaces provided for
within)
1
Date of Inspection/ Visitation
Names of Inspectors or
Visitors
Date of last Inspection/

Visitation
Name of Last
Inspectors/Visitors
Not Applicable
Not Applicable
Defects pointed out in the last

Inspection/Visitation
Not Applicable
To what extent remedied
Not Applicable
Signature of Inspectors/Visitors
A. Teaching Staff : In case this space is less a statement showing the following information may be attached
in this format. (to be filled in by the Dean/Principal of the college).
Department of Anatomy
Post
No.
Name
Qualification with dates

thereof & Where obtained
Experience
As Demonstrator/Tutor
Date
1
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Demonstrator
/Tutor
Any other
Category
2
1
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
(cont.)
Post
Experience
As Assoc. Professor/Reader
15
16
17
18
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Demonstrator/
Tutor
Any other
Category
Institution
From
To
Total
19
Institution
Grand
Total
of
Teaching
Experience
As Professor
20
21
From
To
22
Total
23
Remarks
if any,
24
B. List of non-teaching staff :
Name(s) of staff members
a.
Technical Assistant
b.
Technicians
c.
Modellers
d.
Dissection Hall Attendants
e.
Steno typist
f.
Store Keeper cum clerk
g.
Sweepers
h.
Any other category
C. Give the various sub-section in the Department, if any, like Gross

Anatomy, Neuro-Anatomy, Embrology and Histology.
Is the teaching staff rotated in these sections and if so up to what

level
D.
BUILDINGS :
(h)
Demonstration Room :
a) Number
b) Accommodation (of each demonstration room)
i)
Size
ii)
Capacity
c) Audio-visual equipment available.
ii)
Departmental Library-cum-Seminar Room :
a)
b)
Is there a separate departmental library?
Accommodation
i)
Size
ii)
Capacity
c)
Number of books in Anatomy and allied subjects
d)
List of Journals
(iii)
Practical Laboratories
A)
Dissection Hall
a)
Accommodation
i)
Size
ii)
B)
Capacity
Number and arrangement of tables

i)
Big
ii)
Small
C)
Hygiene and Drainage facilities for Disposal of

Discarded parts. Is there a burial ground ?
a)
Washing arrangement
b)
No. of wash basins provided
c)
No. of lockers provided for students :
d)
Light and exhaust arrangements
e)
Special Instruments other than routine Dissection sets, such

as Electric saw etc.
:
f)
Extra Learning Aids provided in the Dissection Hall

(Skeleton, Charts, Black Board etc.)
g)
Cadaver Preservation Facilities

i)
Embalming room
ii)
Storage Tanks
iii)
iv)
No. of Cadavers available
v)
No. of students allotted per cadaver
Accommodation
D)
Size
Capacity
Histology Laboratory
a)
C)
Number
Size
Cold room/cooling cabinets
B)
Size
Location
Size
Capacity
Working arrangement
Seats available
Cupboard for storage of microscope slides etc.
Number of Microscopes with 1/3, 1/6, & 1/12 objectives
Number of students to each Microscope
E)
F)
Preparation room
Size
Location
Whether Laboratory Manuals kept by students?
Yes
No
G)
Close circuit
teaching aids :
TV/Demonstration
IV)
Research Laboratory
Microscope/any
other
a)
Size
b)
Equipment
c)
Are there any students taken for M.S. or M.Sc. or Ph.D in

Anatomy?
If so how many per year during the last three years?
d)
1)
Diploma
2)
Degree
List of publications by the members of the staff during the last 3

years?
e)
Current problems on which research work is going on and by

whom?
(a statement may be furnished)
f)
Do Undergraduate students in any way participate in them ?
V)
Museum
a)
Size
b)
How are the specimens arranged?
c)
Give Number of each
(d)
Coverage of various fields in Anatomy by Specimens
e)
No. of catalogues of the specimens available to the students.
f)
Specimens in Embroyology, Neuro-Anatomy, Histology, Gross

Anatomy
:
g)
Display of Microscopic sections of normal developing tissues

system wise.
h)
Are the microscopic sections of the specimens available for study to

the students.
i)
Number of Microscope & X-ray view Boxes available to students in

the Museum.
j)
List of exhibits other than the specimens and their arrangement.
k)
Radiological & specialized imaging exhibits:
Number
Type
l)
Charts, Skeletons etc.
m)
Seating arrangement for students
Number
Type
n)
Preparation and storage rooms
o)
Attached rooms
(VI)
OFFICE ACCOMMODATION
a)
Professor and HOD
b)
Associate Professors/Readers :
c)
Asst. Professors/Lecturers
d)
Tutors/Demonstrators
e)
Non-teaching and clerical staff:
E)
TEACHING PROGRAMME
(For duration of the entire course)
I.
Curriculum of studies
(To be filled by the Dean/Principal along
with
Head
of
the
department).
Curriculum in the subject as prescribed
by MCI (a copy of the detailed curriculum
along
with
the
departmental
and
educational objectives of the subject may
be appended).
Is the above curriculum followed in

totality?
If not, what are the variations and

reasons thereof?
(To be filled in by the Inspectors/Visitors).

Does the curriculum of studies adopted by the
training center differ materially from that
recommended by the Medical Council of India.
If so what are the variations and what are

your observations regarding them ?
II. Methodology
(for duration of the entire course)
Number
1)
Didaetic Lectures
2)
Demonstrations
3)
Tutorials
4)
Seminars conducted during the year

Number of students attending each
5)
Practical
6)
Any other teaching/training activities
7)
Is there any integrated teaching?
8)
If yes, details thereof
Records Methods of Assessment thereof
(Time table of lectures, demonstrations,

seminars,
tutorials,
practical
and
dissection may be given).
Signature of Head of the Department
F.
OBSERVATIONS OF THE INSPECTORS/VISITORS
(SIF B-2)

FORM B
On the
PHYSIOLOGY INCLUDING BIO-PHYSICS
Name of Institution ..............

Place ..................
Affiliated to the University of ..
Name of the Head of the Department

(with seal)
Signature of the Head of the

Department

Inspector, who shall examine the information already furnished & gather
such additional information as may be necessary to fill in the spaces
provided for within)
1.
Date of Inspection/Visitation
2.
Names of Inspectors or Visitors
3.
Date of last Inspection/Visitation
4.
Names of last Inspectors/Visitors
Defects pointed out in the last Inspection /

Visitation
A. Teaching Staff : In case this space is less a statement showing the following information may be
attached in this format. (to be filled in by the Dean/Principal of the college).
Department of Physiology including Bio-physics
Post
No.
Name

Experience
Date
1
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Demonstrator
/Tutor
Any other
Category
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
(cont.)
Post
Experience
15
16
17
18
Professor
Associate/
Professor/
Reader
Asst.Prof.
/Lecturer
Demonstrator/
Tutor
Any other
Category
Institution
From
To
Total
19
Institution
As Professor
20
21
From
To
22
Total
Grand
Total
of
Teaching
Experience
Remarks if
any,
23
24
B.
List of non-teaching staff :

Name (s) of staff members
C.
a.
Technical Assistant
b.
Technicians
c.
Store Keeper-cum-Clerk
d.
Laboratory Attendance
e.
Steno-typist
f.
Sweepers
g.
Any other category
Buildings :
b)
(i)
a.
Number
Accommodation of each demonstration room :

Size
Capacity
c)
Audio-Visual equipment available :
(ii)
Practical Laboratories :
Amphibian
Laboratory
a)
b)
c)
Accommodation
Size
Capacity
Working arrangement
Seats available
Water supply
Sinks
Electrical Points
Cupboard for storage of

microscopes slides etc
Main Equipment available
Mammalian
Laboratory
Hematology
Laboratory
Clinical
Physiology
Laboratory
d)
Number of Microscopes
e)
No. of students to each microscope
f)
Preparation room
g)
Size
Location
Yes
No
(h)
Close circuit TV/demonstration Microscope/any other teaching aids.
III)
IV)
DEPARTMENTAL LIBRARY-CUM-SEMINAR ROOM
a.
b)
Accommodation
Size
Capacity
c)
Number of Books in Physiology including Biophysics
d)
List of Journals
RESEARCH LABORATORY
a)
Size
b)
Equipment
c)
Are there any students taken for

M.D. or Ph.D. in Physiology
Including Bio-physics?
If so, how many per year during the

last three years.
1)
Diploma
2)
Degree
V)
d)
List of publications by the members

of the staff during the last 3 years ?
e)
Current problems on which research

work is going on and by whom?
f)
Do Undergraduate students in any

way participate in them?
a)
Professor and HOD
b)
c)
d)
e)
D.
TEACHING PROGRAMME
I.
with
Head
of
the
department).
along
with
the
departmental
and
be appended).

totality?

reasons thereof?

Does the curriculum of studies adopted by
the training center differ materially from
that recommended by the Medical Council
of India.

E.
METHODOLOGY
Number
1)
Didaetic Lectures
2)
Demonstrations
3)
Tutorials
4)
Seminars conducted during the year.

(Number of students attending each)
5)
Practicals
6)
7)

If yes,
8)

seminars,
tutorials,
practical
and
F.
(SIF B-3)

FORM B
On the
BIOCHEMISTRY
Name of Institution .............

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
A.
Teaching Staff : In case this space is less a statement showing the following information may be
Department of Biochemistry
Post
No.
Name

Experience
Date
1
Professor
Associate/
Professor/
Reader
Asst. prof.
/Lecturer
Demonstrator
/Tutor
Any other
Category
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
(cont.)
Post
Experience
15
16
17
18
Professor
Associate/
Professor/
Reader
Asst. prof.
/Lecturer
Demonstrator/
Tutor
Any other
Category
Institution
From
To
Total
19
Institution
As Professor
20
21
From
To
22
Total
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
B.
LIST OF NON-TEACHING STAFF :

C.
a.
Technical Assistant
b.
Technicians
c.
Store Keeper-cum-Clerk
d.
e.
Sweepers
f.
Any other category
BUILDINGS :
(i)
i
a)
Number
b)
Accommodation
Size
Capacity
c)
II)
PRACTICAL CLASS ROOM/LABORATORIES :

a)
b)
c)
d)
e)
Accommodation
Size
Capacity
Working arrangement
Seats available
Water supply
Sinks
Electric points
Cupboard for storage of microscopes
Preparation room
Size
Capacity
Whether laboratory manual kept by students?
Yes
No
Close circuit T.V./Any other teaching aids.
III)
c)
DEPARTMENTAL LIBRARY-CUM-SEMINAR ROOM :

a)
b)
Accommodation
Size
Capacity
Number of Books in Biochemistry and

allied subjects.
d)
List of Journals
(IV)
RESEARCH LABORATORIES
a)
Size
b)
Equipment
c)

M.D. or M.Sc. or Ph.D. in
Biochemistry?
If so how many per year during the

last three years.
1)
Diploma
2)
(V)
Degree
d)

of the staff during the last 3 years.
e)
Current problems in which research

work is going on and by whom? (a
statement may be furnished)
f)

a)
Professor and HOD
b)
c)
d)
e)
D.
TEACHING PROGRAMME

I.
with
Head
of
the
department).
along
with
the
departmental
and
be appended).

totality?
If not, what are the variations and reasons thereof?


II. METHODOLOGY
Number
1)
Didactic Lectures
2)
Demonstrations
3)
Tutorials
4)

5)
Practical
6)
7)
If yes,
8)

seminars,
tutorials,
practical
and
E.
SERVICE LABORATORY IN THE TEACHING HOSPITAL/COLLEGE :
a)
b)
Is there separate biochemistry laboratory in the hospital?
Yes
No
If yes, control and supervision

i)
Whether departmental (college)
ii)
Under Medical Superintendent (Hospital)
iii)
If departmental, method of posting and rotation of medical &

non-medical staff
c)
Size of the laboratory :
d)
Investigative equipment available (Attach list)
e)
Staff
Names
Qualifications
Designation
1.
Medical
Names
Qualifications
2.
Non-Medical
f)
Report giving details of work done during the last 1 year to be attached :
g)
Are the students (UG/PG) posted in the hospital laboratory?
Yes
Designation
No
F.
IS THERE ANY EMERGENCY HOSPITAL BIOCHEMISTRY SERVICE
If so give details of
a)
Staff employed
b)
Average no. of tests done during one

month (in emergency laboratory)
c)
Is a record of these test maintained
G.
(SIF B-4)

FORM B
On the
PATHOLOGY

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Pathology
Post
No.
Name

Experience
As Demonstrator/Tutor/Sr.
Res./Registrar
Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Registrar/
Sr.
Resident/
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Demonstrator/Tutor
Any other
Category
(cont.)
Post
Experience
15
16
17
18
Professor
Associate
Professor/Read
er
Asst. Prof.
/Lecturer
Institution
From
To
Total
19
Institution
Grand
Total
of
Teaching
Experience
As Professor
20
21
From
To
22
Total
23
Remarks
if any,
24
Registrar/
Sr. Resident/
Demonstrator/
Tutor
Any other
Category
B.

a.
Artist
b.
Technical Assistant
c.
Technicians
d.
Laboratory Attendants
e.
Steno-typist
f.
Clerk
g.
Store Keeper
h.
Record Clerk
i.
Sweepers
j.
C.
Any other category
Give the various sub-section in the

department
like
Morbid
Anatomy,
Hostopathology, Cytopathology, Clinical
Pathology/Haematology and any other
specialized section.
Is the teaching staff rotated in these sections?
If so, upto what level?
D.
BUILDINGS :
(I)
a)
Number
b)
Accommodation
Size
Capacity
c)
Audio-Visual equipment available
(ii)
PRACTICAL LABORATORIES :
Morbid/
Anatomy
Histo-/
Cyto-/
Pathology Pathology
Clinical/ Haematology
Pathology
________________________________________________________________________________________________________
a) Accommodation
Size
Capacity
b) Working arrangement
Seats available
Water supply
Sinks
Electrical Points
Cupboard for storage of

microscopes slides etc
c) Main Equipment available
d) Number of Microscopes
e) No. of students to each microscope :
f)
g)
Preparation room :
Size
Location
Yes
No
h)
Close circuit TV/demonstration Microscope/any other teaching aids.
iii)
Service Laboratory in the teaching hospital/college :

Histopathology
Cytopathology
Haematology
Any
other
Specialized
Section like
immunology
a)
Are there separate service laboratories?
Yes
No
b)
If yes, control and supervision :

i)
Whether departmental (college)
ii)
Under Medical Superintendent (Hospital)
iii)
If departmental, method of posting and rotation of

medical & non-medical staff :
c)
Size of laboratory
d)
Investigate equipment available (Attach list)
e)
Staff
1.
Medical
Name(s)
Qualifications
Designation
Name(s)
2.
Non medical
f)
Report giving details of work done

in each service laboratory separately
during the last 1 year (to be attached).
g)
Are the students (UG/PG) posted in the

hospital laboratory.
Yes
No
Qualifications
Designation
(iv)
Is there any emergency hospital Pathology service?

V)
a)
Staff employed
b)
Average no. of tests done during one month

in emergency hospital pathology laboratory.
c)
Is a record of these tests maintained.
Is there a separate
a)
b)
c)
VI)
Balance room
Yes
No
Store room
Yes
No
High speed centrifuge room
Yes
No
MUSEUM :
a)
Size
b)
How are specimens arranged ?
c)
Give number of each :
d)
Mounted
Unmounted
Are the microscopic section of

Specimens available for study to
the students?
If so, in the museum or in some

other room
e)
No. of microscope available to the

students in the museum.
f)
List of charts, photographs, models

and other exhibits other than the
specimens and their arrangements.
g)
No. of catalogues of the specimens

available to the students.
h)
seating arrangement for students
Type
Number
i)
Ante-room
Yes
No
VII)
AUTOPSY BLOCK
a)
distance from the department
b)
size
c)
student observation facilities

1.
2.
3.
level type
gallery type
capacity
d)
No. of autopsy tables available :
e)
Light, ventilation and exhaust

arrangements:
f)
Water supply, drainage, washing

arrangements & disposal of waste.
g)
Fly proofing
h)
cold room/cooling cabinets :

1.
2.
i)
size
Capacity
Equipments
No. of pathological autopsies
j)
1st year
2nd Year
3rd Year
Per year for the last 3 years :
k)
Is there an emergency autopsy

service?
l)
How are the autopsy reports

maintained in the department?
Do undergraduate students in any

way participate in the conduction of
autopsies?
Ante-room
m)
n)
o)
Yes
No
Waiting hall and office
VIII) DEPARTMENTAL LIBRARY-CUM-SEMINAR ROOM :

a)
b)
Accommodation
Size
Capacity
c)
Number of books in Pathology and allied subjects.
d)
List of Journals
IX)
RESEARCH LABORATORY :
a)
Size
b)
Equipment
c)

Diploma in Pathology, M.D. or
Ph.D. in Pathology?
If so, how many per year during the
last three years.
1)
Diploma
2)
Degree
d)

of the staff during the last 3 years
e)

(a statement may be furnished )
f)
X)

a)
Professor & H.O.D.
X)
b)
Associate Professor/Reader
c)
Asst. Professor/Lecturers
d)
e)
Non-teaching and Clerical Staff
BLOOD BANK
a)
b)
Is there any blood bank in the hospital?
Yes
No
If yes, is it approved and licensed by competent authority?
Please mention the validation period of the license :
c)
Is it air-conditioned
d)
No
Partly
Completely
Control of Blood Bank
E)
i)
Is it under the department of

pathology?
ii)
Is it under the
Superintendent?
e)
If departmental method of posting

and rotation of Medical and nonmedical staff.
f)
Number of issued units of blood per

month :
g)
Number of donors blood per month
h)
Staff details of both medical and

non-medical.
i)
List the number of tests done in the

blood bank Hepatitis B, Hepatitis
C, Syphilis, Malaria, Rh-testing,
HIV, blood grouping etc. (Report
giving details of work done during
the last 1 year to be attached).
TEACHING PROGRAMME
I.
Medical

with
Head
of
the
department).
along
with
the
departmental
and
be appended).

totality?

reasons thereof?

of India.

II. Methodology
Number
1)
Didaetic Lectures
2)
Demonstrations
3)
Tutorials
4)

5)
Practicals
6)
7)
If yes, details thereof.

8)

seminars,
tutorials,
practical
and
F.
(SIF B-5)

FORM B
On the
MICROBIOLOGY

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Microbiology
Post
No.
Name

Experience
Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Demonstra
tor/Tutor
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Any other
Category
(cont.)
Post
Experience
15
16
17
18
Professor
Associate
Professor/Read
er
Asst. prof.
/Lecturer
Demonstrator/
Tutor
Institution
From
To
Total
19
Institution
As Professor
20
21
From
To
22
Total
Grand
Total
of
Teaching
Experience
Remarks
if any,
23
24
Any other
Category
B.

C.
a.
Technical Assistant
b.
Technicians
c.
d.
Store keeper
e.
Record clerk
f.
Steno-typist
g.
Sweepers
h.
Any other category
Buildings :
(i)
ii
a)
Number
b)
Accommodation
Size
Capacity
c)
ii)
Practical laboratories:
a)
b)
Accommodation
Size
Capacity
Working arrangement
Seats available
Water supply
Sinks
Electric points
Cupboard for storage of microscopes
c)
Main equipments available
d)
e)
Number of students to each microscopes
f)
preparation room
Size
Location
g)
h)
Whether laboratory manual kept by students?
Yes
No
Close circuit T.V./any other teaching aids.
iii)
SERVICE LABORATORY IN THE TEACHING HOSPITAL/COLLEGE :

Bacteriology Serology
Including
Anaerobic
a)
Are there separate

Service Laboratories
b)
Yes
No
If yes, control and

supervision :
i)
Whether departmental
(college)
ii)
Under Medial
Superintendent (Hospital)
iii)
If departmental, method of
Posting and rotation of
Medical & non-medical
Virology
Para-SerologyMycology
Tuberculosis
Immuno
logy
Any
other
Staff
e)
c)
Size of the laboratory
Investigative equipment available

(Attach list)
e)
Staff
1.
Medical
Names
Qualifications
Designation
Non-Medical
Name(s)
f)
Report giving details of work

done during the last 1 year to
be attached.
g)
Are the students (UG/PG) posted

in the hospital laboratory.
Yes
No
Qualifications
Designation
IV)
Is there any emergency hospital

microbiology service.
a)
Staff employed
b)
Average no. of tests done during one

Month in the emergency hospital
Microbiology laboratory.
c)
Is a record of these test maintained
V)
a. Is there a separate media preparation and

storage area?
Yes
Size
No
b.
Autoclaving room
Yes
Size
No
c.
Washing and drying room

Yes
(VI)

a)
Is there a separate departmental

Library-cum-Seminar room?
b)
Accommodation
Size
VI)
Capacity
c)
Number of Books in Microbiology and allied subjects.
d)
List of Journals
RESEARCH LABORATORIES :
a)
Size
b)
Equipment
c)

M.D. or M.Sc. or Ph.D. in
Microbiology?

last three years.
d)
1)
Diploma
2)
Degree

of the staff during the last 3 years.
e)

f)

(VII)
a)
Professor and H.O.D.
b)
Associate Professor/Reader
c)
Asst. Professor/Lecturers
d)
Tutors/Demonstrators.
e)
Non-teaching and Clerical staff
D.
TEACHING PROGRAMME.
I.
(To be filled by the Dean/Principal
along with the Head of department).
Curriculum in the subject as
prescribed by MCI (A copy of
detailed curriculum along with the
departmental
and
educational
objectives of the subject may be
appended).

totality?
If not, what are the variations and reasons

thereof?
(To be filled in by the Inspectors/Visitors). Does

the curriculum of studies adopted by the
If so what are the variations and what are your
observations regarding them ?
II. Methodology
Number
1)
Didactic Lectures
2)
Demonstrations
3)
Tutorials
4)

5)
Practicals
6)
Any
:
7)
other
teaching/training
activities
If yes,
8)

:

seminars,
tutorials,
practical
and

F.
(SIF B-6)

FORM B
On the
PHARMACOLOGY

Place ..................
Name of the Head of the Department ..

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Pharmacology
Post
No.
Name

Experience
Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Demonstra
tor/Tutor
Any other
Category
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
(cont.)
Post
Experience
15
16
17
18
Professor
Associate
Professor/Read
er
Asst. prof.
/Lecturer
Demonstrator/
Tutor
Institution
From
To
Total
19
Institution
As Professor
20
21
From
To
22
Total
Grand
Total
of
Teaching
Experience
Remarks if
any,
23
24
Any other
Category
B.

C.
a.
Pharmaceutical Chemist
b.
Technical Assistant
c.
Technicians
d.
Store keeper-cum-clerk
e.
Steno-typist
f.
g.
Sweepers
h.
Any other category
Buildings :
(i)
iii
a)
Number
b)
Accommodation
Size

c)
Capacity
(ii)
PRACTICAL LABORATORIES :
Experimental Pharmacology
a)
Accommodation
Size
Capacity
b)
Working arrangement
Seats available
c)
Main Equipment available
d)
Ante-room/preparation room
e)
Size
Location
Whether Laboratory Manuals

Kept by students?
Yes
Clinical Pharmacology & Pharmacy

f)
No
Close circuits TV/any other teaching aids
(iii)
IV)
Museum
a)
Size
b)
How are the drug sample arranged?
c)
Number of catalogues of the

samples available to the students :
d)
Total number of drug samples :
e)
List of charts, photograph and other

exhibits and their arrangement
f)
Is there any section

History of Medicine?
depicting
a)
b)
Accommodation
Size
Capacity
c)
Number of Books in Pharmacology?
d)
List of Journals
(VI)
Research Laboratory :
a)
Size
b)
Equipment
c)

M.D. or Ph.D. in Pharmacology?

last three years.
d)
1)
Diploma
2)
Degree

of the staff during the last 3 years?
e)

f)

(VII) OFFICE ACCOMMODATION
a)
Professor and HOD
b)
c)
d)
e)
D.
TEACHING PROGRAMME

I.
with
Head
of
the
department).
along
with
the
departmental
and
be appended).

totality?

reasons thereof?


of India.
II. Methodology
Number
1)
Didaetic Lectures
2)
Demonstrations
3)
Tutorials
4)
Seminars
-
conducted during the year.
Number of students attending each
5)
Practicals
6)
7)

If yes,
8)

seminars,
tutorials,
practical
and
F.
(SIF B-7)

FORM B
On the
FORENSIC MEDICINE

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Forensic Medicine
Post
No.
Name

Experience
Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Demonstra
tor/Tutor
Any other
Category
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
(cont.)
Post
Experience
15
16
17
18
Professor
Associate
Professor/Read
er
Asst. Prof.
/Lecturer
Demonstrator/
Tutor
Institution
From
To
Total
19
Institution
Grand
Total
of
Teaching
Experience
As Professor
20
21
From
To
22
Total
23
Remarks
if any,
24
Any other
Category
B.

C.
a..
Technical Assistant
b.
Technicians
c.
d.
Steno-typist
e.
Store keeper-cum-clerk
f.
Sweepers
g.
Any other category
Buildings :
(i)
iv
c)
a)
Number
b)
Accommodation
Size
Capacity

Video Camera, TV & VCR etc.
ii)
Museum :
a)
Size
b)
How are specimens arranged ?
c)
Give number of each :
Mounted
Unmounted
d)
Proto-type fire and other arms.
e)
Wax Models
(iii)
f)
Poisons
g)
List of charts, photographs, models

and other exhibits other than the
specimens and their arrangements.
h)

i)
seating arrangement for students
Type
Number
Department of Radiology
a.
Do adequate facilities exist for

taking skiagrams of living and dead
persons.
b.
Do adequate facilities in the

department
of
Biochemistry,
Histopathology,
Bacteriology
&
Serology exist for Undertaking the
examination
of
medico-legal
materials?
(IV)
(V)
Casualty Department :
a)
Accommodation
b)
Are the facilities for reception,

Examination, treatment of medicolegal emergencies and cases of
poisoning adequate?
c)
The number of cases of medico-legal

Trauma, Sexual assault, age and
poisoning etc. dealt by the casualty
department during the last one year
may be indicated.
Mortuary Block
a)
Distance from the department
b)
Size
c)
student observation facilities

1.
level type
2.
gallery type
3.
capacity
d)
No. of autopsy tables available :
e)
light, ventilation and exhaust arrangements :
f)
Water supply, drainage, washing

arrangements & disposal of waste.
g)
Fly proofing
h)
Cold room/cooling cabinets:

1.
Size
2.
Capacity
i)
Equipments
j)
No. of medico legal

postmortems done during
the last 3 years :
k)
No. of students attending one
1st year
2nd year 3rd year
postmortem
(VI)
l)
No. of postmortem done by

a students during the course
n)
Whether record of postmortem

Cases kept by students?
Laboratory
a)
b)
c)
Accommodation
Size
Capacity
Working arrangement
Seats available
Water supply
Sinks
Main equipment available
d)
e)
Any other teaching aids
(VII) Departmental Library-cum-Seminar Room :
a)
Is there
library?
separate
b)
Accommodation
i)
Size
ii)
Capacity
departmental
c)
Number of books in Anatomy and

allied subjects
:
d)
List of Journals
(VIII)
Research Laboratory
a)
Size
b)
Equipment
c)

D.F.M./M.D. or Ph.D. in Forensic
Medicine?

last three years?
1) Diploma
2) Degree
d)

e)

f)
IX)

way participate in them ?
D)
a)
Professor and HOD
b)
c)
d)
e)
TEACHING PROGRAMME

1.
with
Head
of
the
department).
along with the departmental and
be appended).

totality?

reasons thereof?

of India.
II. Methodology
Number
1)
Didactic Lectures
2)
Demonstrations
3)
Tutorials
4)

5)
Practicals
6)
7)
8)

seminars,
tutorials,
practical
and
E.
(SIF B-8)

FORM B
On the
COMMUNITY MEDICINE/PREVENTIVE AND SOCIAL MEDICINE

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Community Medicine/Preventive and Social Medicine
Post
No.
Name

Experience
As Demonstrator/Tutor/Sr.
Res./Registrar
Date
1
Professor
Associate/
Professor/
Reader
Asst.Prof.
/Lecturer
Registrar/
Sr. Resident/
Demonstrator
/Tutor
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Any other
Category
(cont.)
Post
Experience
15
16
17
18
Professor
Associate
Professor/Read
er
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident/
Demonstrator/
Institution
From
To
Total
19
Institution
As Professor
20
21
From
To
22
Total
Grand
Total
of
Teaching
Experience
Remarks
if any,
23
24
Tutor
Any other
Category
B.

a.
Medical Social Worker
b.
Technical Assistant
c.
Technicians
d.
Stenographer
e.
Record Clerk
f.
Storekeeper
g.
Sweepers
h.
Any other category
C.
STAFF FOR RURAL TRAINING HEALTH CENTRE :

(including field work and epidemiological studies)
a.
Medical Officer of Health cum-Lecturer/

Assistant Professor
b.
Lady Medical officer
c.
d.
Public Health Nurse
e.
Health Inspectors
f.
Health Educators
g.
Technical Assistant
h.
Technician
i.
Peon
j.
Van-driver
k.
Store keeper
l.
Record Clerk
m.
Sweeper
n.
Any other category
D.)
STAFF FOR UBRAN TRAINING HEALTH CENTRE

(Including field work and epidemiological studies.)
a.
Medical Officer of Health cum-Lecturer/

Assistant Professor
b.
Lady Medical officer
c.
d.
Public Health Nurse
e.
Health Inspectors
f.
Health Educators
g.
Technical Assistant
h.
Technician
i.
Peon
j.
Van-driver
k.
Store keeper
l.
Record Clerk
m.
Sweeper
n.
Any other category
E.
BUILDINGS :
(g)
a) Number
b) Accommodation (of each demonstration room)

i)
ii)
Size
Capacity
c) Audio-visual equipment available.
(ii)
Laboratory
a) Accommodation
b)
Size
Capacity
Working arrangement
Seats available
Water supply
Sinks
Electric points
Cupboard for storage of microscope, slides etc
c)
d)
d)
(iii)
Yes
No
Close circuit TV/any other teaching aids.
Museum
a)
Size
b)
:
How are the specimens arranged?
c)
Give Number of each
d)
Coverage of various fields in

Community Medicine by charts,
Models etc.
e)

f)
List of exhibits, Charts, Photographs

& other materials and their
arrangement.
g)
Seating arrangement for students
(IV)
Type
Number
(V)
a)
b)
Accommodation
i)
Size
ii)
Capacity
c)
Number of Books in Community Medicine and allied

subjects.
d)
List of journals
Research Laboratory
a)
Size
b)
Equipment
c)

DPH/M.D./Ph.D. in Community
Medicine?

last three years?
VI)
1)
Diploma
2)
Degree
d)

e)

f)

a)
b)
Professor and HOD

:
c)
d)
Statistician-cum-Lecturer
(vii)
e)
Epidemiologist-cum-Lecturer :
f)
Tutors/Demonstrators/Sr. Residents:
g)
Departmental Office-cum-Clerical room
h)
Non-teaching staff
HEALTH CENTRES (Rural and Urban)
R.H.C./P.H.C.
-------------------I
II
III
a)
Names of the Centers :
b)
Location of each Center :
c)
Population covered by each center
d)
Distance from the college
URBAN
HEALTH
CENTRE
e)
Transport facilities for :
1.
2.
3.
Students & Interns
Staff
Supportive Staff
(i)
Number of Vehicles
(ii)
Capacity of each Vehicle
Control of Vehicles
Departmental
Central
f)
Staff of the Centers
g)
Hostel facilities at the Rural Health Centres :
h)
Messing facilities available or not.
(i)
Working arrangement/type of control of Health Centres :
(i)
Total (Admn. & Financial) control with the college
(ii)
Partial (only for training) control
F.)
TEACHING PROGRAMME
I)
with
Head
of
the
department).
along
with
the
departmental
and
be appended).

totality?
(To be filled in by the Inspectors/Visitors). Does the curriculum of

studies adopted by the training center differ materially from that
If so what are the variations and what are your observations

regarding them ?
II. Methodology
Number
1st yr.
1)
Didaetic Lectures
2)
Demonstrations
3)
Tutorials
2nd yr.
3rd yr.
4th yr.
4)

5)
Practicals
a)
Subject
Time
Spent
b)
Subject
Time
Spent
Rural Practice Field :

Year of the
student in
Medical
College
Type of instruction
Observation
Demonstration
Participation
Urban Practice Field :

Year of
student
Medical
College
the
Type of instruction
in Observation
Demonstration Participation
c)
What field visits and of what duration are

organized by the department for the
following subject and how far the following
subjects and how far have the students
participated in the program?
1.
Vital statistics
2.
Environmental sanitation
3.
Communicable/non-communicable Diseases.
4.
Public Health Laboratory Service
5.
Maternal & Child Health & Family Welfare planning
6.
School Health Service
7.
Others (Specify)
d)
Clinical Social Case reviews How many

are reviewed by a student during his/her
career in the Medical College How are
the records kept?
e)
Study of Family & Community Health

Survey
f)
Family case studies
6.
TEACHING HOSPITAL
1.
In patient department
2.
a.
Tuberculosis
b.
Venereal Diseases
No. of Beds used in each

specialty for teaching the
subject of preventive and
Social Medicine/Community
Medicine.
Leprosy
Poliomylitis
Infectious & Communicable diseases
Non-Communicable diseases
Hypertension
Diabetes
Goiter
Rheumatism
Cancer &
Other
Is the hospital teaching program in

Community Medicine/Preventive & Social
Medicine organized and Co-ordinate by the
Dean/Principal of the college and other

college staff?
3.
Average no. of students posted at a time :

To which year do they belong?
(a list of posting for clerkship in preventive
and social medicine/community medicine
may be furnished)
4.
Clinical Teaching
a.
bedside clinics
b.
by whom given
c.
How often during a week?
d.
e.
Do students writes case histories in a prescribed book?

Are they corrected, if so by whom?
f.
Do students conduct clinical social

case reviews by actual visit to the
family?
If so, how many and how they are
supervised?
g.
Are these reviews assessed by the

staff of the department?
h.
Are there facilities for teaching and

demonstration for preventive health
services in any infectious diseases?
i.
5.
If so what type of cases are available

for teaching and demonstration and
how much time is allotted for this
during the course of study?
Record and filing system at the rural and

urban field practice areas.
Are family folders introduced or in the

maintenance of records?
6.
Outpatient Department
a.
Arrangement
students
for
case
study
b.
Clinical outpatient teaching
for
c.
d.
No. of demonstrations given by the Preventive and Social

Medicine/Community Medicine department in collaboration
with other clinical departments in the outpatient department
and on what subjects.
Is the department running immunization
clinic?
Yes
No.
If yes, frequency per week.

Are Undergraduate students posted in the clinic?
7)
Any other teaching/training activities:
8)
Is there any integrated teaching/If yes, details thereof.
9)
Records :
Methods of Assessment thereof :

seminars, tutorials, practical and field
activities may be given)
10)
INTERNSHIP TRAINING
1.
Period of posting in the department
2.
Pattern of posting
a.
Period
Rural Health Centre/Primary Health Centre
3.
b.
Urban Health Centre
c.
Other postings like
National Health Programmes
Clinics
Immunization
School Health
Family Welfare Planning
Any other postings
Method
of
Assessment
Internship
(Please
attach
a
copy
logbook/assessment sheet).
for
of

G.
(SIF B-9)

FORM B
On the
GENERAL MEDICINE
INCLUDING TURBERCULOSIS AND RESPIRATORY DISEASES, DERMATOLOGY,
VENEREOLOGY AND LEPROSY & PSYCHIATRY


Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
A1 : Department of General Medicine
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Registrar/
Sr.
Resident
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Jr.
Resident
Any other
Category
(cont.)
Post
Experience
Professor
Associate
Professor/
Reader
Asst.Prof.
/Lecturer
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remarks
if any,
As Professor
Institution
19
From
20
To
21
Total
22
23
24
Registrar/
Sr. Resident
Jr. Resident
Any other
Category
A2 : Department of Tuberculosis & Respiratory Diseases
Post
No.
Name

Date
1
Professor
Associate
Professor/Rea
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
der
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
(cont.)
Post
Experience
Grand
Total
of
Teaching
Experience
As Professor
Remarks
if any,
Institution
From
15
16
To
17
Total
18
Institution
19
From
20
To
21
Total
22
23
24
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
Any other
Category
A3 : Department of Dermatology, Venercology and Leprosy
Post
No.
Name

Date
1
Professor
Associate
Professor/Rea
der
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
(cont.)
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Post
Experience
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
A4 : Department of Psychiatry
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Any other
Category
(cont.)
Post
Experience
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Jr. Resident
Any other
category
B.
Nomenclature

General Medicine
a. E.C.G. Technician
b. Technical Assistant
c. Technician
TB & Resp.
Diseases
Derm., Ven. & Lep.
Psychiatry
d. Lab. Attendants
Nomenclature

General Medicine
e.
Steno-typist
f.
Record Clerk
g. TB & Chest Diseases Health

visitor
TB & Resp.
Diseases
Derm., Ven. & Lep.
Psychiatry
h. Psychiatric Social Workers
i. Any other category
C.
BUILDINGS :
Gen.
Medicine
(i) Clinical Demonstration

Room
a)
Number
b)
Accommodation (of
each demonstration
room)
.
i)
ii)
c)
(ii)
Size
Capacity
Audio-visual equipment
available.
Departmental Library-cum
Seminar Room :
a)
Is there a separate
Departmental library?
b)
Accommodation
i)
Size
ii)
Capacity
c)
Number of Books in
General Medicine.
TB & Resp. dis.

Derm., Ven. & Lep.
TB
Resp. Dis.
Derm.,
Ven. &
Lep.
Psychiatry
Psychiatry and
allied subjects
Gen.
Medicine
d)
(iii)
List of Journals
Research Laboratory
a)
Size
b)
Equipment
c)
Are there any students

taken for Diploma/
M.D./Ph.D. in Gen. Med./
TB & RD/DVD/Psy?
If so how may per year
During the last three years
d)
i)
Diploma
ii)
Degree
List of publications by
TB
Resp. Dis.
Derm.,
Ven. &
Lep.
Psychiatry
the members of the staff

during the last 3 years.
Gen.
Medicine
(iv)
e)
Current problems
Research work is going on
and by whom? (a statement
may be furnished)
f)
Do Undergraduate students
In any way participate in
them?
TB
Resp. Dis.
a)
Professor and HOD
b)
Derm.,
Ven. &
Lep.
Psychiatry
c)
d)
Registrars/Sr. Residents:
Gen.
Medicine
e)
Jr. Residents
f)
Non-teaching and
Clerical staff.
TB
Resp. Dis.
Derm.,
Ven. &
Lep.
Psychiatry
D.
1)
TEACHING HOSPITAL
Inpatient department :
Number of
Teaching Beds
Number of Units
Number of beds
Unit wise
staff
composition
With names
Qualification
& Designation
of staff
____________________________________________________________________________________________________________
Medicine and allied specialisites :
a)
General Medicine
b)
Tuberculosis & Respiratory

Diseases
----do----
Dermatology, Venereology & Leprosy
----do----
c)
A separate sheet
may be attached
d)
Psychiatry
2.
Indoor admissions
----do---General
TB & RD
DVD
Psychiatry
_______________________________________________________________________
1.
Annual admissions
2.
Average Bed occupancy per day

(Percentage of Teaching beds)
3)
INTENSIVE CARE
No. of beds
a)
Intensive Care Unit (I.C.U.)
b)
Intensive Coronary Care

Unit (I.C.C.U.)
c)
Intensive Care in TB &

Respiratory diseases
d)
Other intensive Care

Areas, if any.
Equipments available
4)
MAJOR EQUIPMENT AVALIABLE IN THE DEPARTMENT :
Names of equipment
a)
General Medicine
b)
Tuberculosis & Respiratory

Diseases
c)
Dermatology, Venearology &

Leprosy
d)
Psychiatry
5)
OUT-PATIENT DEPARTMENT :
a)
Building General layout
b)
Is outpatient service Department wise
c)
Arrangement for clinical

Instructions to student in
General Medicine & Allied specialties
d)
Average Daily OPD Attendance
General
Medicine
TB & RD
DVD
Psychiatry
____________________________________________________________
1.
Old Patients
2.
New Patients
3.
Total
Teaching and training facilities :

General
Derm
Psy.
Ven. &
Lep.
________________________________________________
A.
B.
A.
TB & RD
In O.P.D.
a)
Clinical demonstration room :
b)
Number of rooms in the OPD

For seeing the patients
by various faculty members
and resident staff
In-door
a)
Bedside teaching
b)
Clinical demonstration room/

seminar room
TEACHING PROGRAMME

1.
with
Head
of
the
department).
Curriculum in the subjects of Gen. Med.,
T.B. & RD, Derm., Ven. & Leprosy and
Psychiatry as prescribed by MCI (a copy of
the detailed curriculum along with the
departmental and educational objectives

of the subject may be appended).
Is the
totality?
above
curriculum
followed
in
If not, what are the variations and reasons

thereof?

recommended by Medical Council of India.

your observations regarding them?
II.
Methodology
Number
__________________________________________________________
General
Medicine
TB & RD
DVD Psychiatry
______________________________________________________
1)
Total
of clinical postings
2)
Didactic Lecturers
3)
Demonstrations
Number
__________________________________________________________
General
TB & RD
DVD Psychiatry
Medicine
______________________________________________________
4)
Tutorials
5)
Seminars conducted
during the year
Number of students
Attending each
6)
Practical
7)
Bedside Clinics
8)
How may hours does a

Student spend daily in the
wards for clerkship.
9)
Average Number of students

Posted at a time for indoor/OPD
Postings.
10)
Do students write case histories

In a prescribed book?
11)
Are they corrected ?
Number
__________________________________________________________
General
TB & RD
DVD Psychiatry
Medicine
______________________________________________________
12)
13)
14)
If so, by whom
Is the clinical work done

In the wards by the
Students assessed
Periodically?
If so, how often and by

whom?
15)
Total period of attendance

in OPD by a student
throughout clinical
training.
16)
Is it done concurrently with

The inpatients ward postings?
17)
Who gives them training to

attend to casualties?
Number
__________________________________________________________
General
TB & RD
DVD Psychiatry
Medicine
______________________________________________________
18)
How is the outpatients

Teaching organized?
19)
Do students attend
Clinicoathological
Conferences?
20)
If so, on an average, how

Often during the whole period
Of medicine and allied
specialties postings?
21)
Any other teaching/training

activities:
22)

Number
__________________________________________________________
General
TB & RD
DVD Psychiatry
Medicine
______________________________________________________
23)
Records Methods of
Assessment thereof
(Time table of lecturers,

demonstrations, seminars,
tutorials, practicals, OPD and
indoor postings etc. may be
given).
24)
Internship Training Programme

a) Period of posting
In the department
b) Method of assessment of
Internship (please attach a
Copy of log book/assessment
Sheet)
Signature of Dean/Principal
General Medicine :
Tuberculosis and Respiratory diseases :
Dermatology , Venerecology & Leprosy
Psychiatry
F.
OBSERVATIONS OF THE INSPECTORS/VISITORS :
(SIF B-10)

FORM B
On the
PAEDIATRICS

Place ..................

(with seal)
Signature of the

1.
2.
3.
4.

Visitation
Department of Pediatrics
Post
No.
Name

Experience
As Resident/Registrar
Date
1
Professor
Associate
Professor/
Reader
Asst.
Prof.
/Lecturer
Sr.
Resident/
Registrar
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Jr.
Resident
Any other
Category
(cont.)
Post
Experience
Professor
Associate/
Professor/
Reader
Asst.
Prof.
/Lecturer
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remarks
if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Sr.
Resident/
Registrar
Jr. Resident
Any other
category
B.

a.
Child Psychologist
b.
Health Educator
c.
Technical Assistant
d.
Technician
e.
f.
Store Keeper
g.
Steno-typist
h.
Record Clerk
i.
Social Worker
Any other category
C.
Buildings :
(i)
Clinical Demonstration Room :
a)
Number
b)
Accommodation (of each demonstration room)
c)
(ii)
i)
Size
ii)
Capacity
Audio-Visual equipment available.
Departmental Library cum- Seminar Room :
a)
b)
c)
Accommodation
i)
Size
ii)
Capacity
Number of books in Pediatrics including Neonatology :
d)
iii)
List of Journals
Research Laboratory
a)
Size
b)
Equipment
c)

Diploma/M.D. in Pediatrics

last three years?
1)
Diploma
vi
2)
Degree
d)

(IV)
e)

work is going on and by whom? (a
statement may be furnished)
f)

a)
Professor and HOD
b)
c)
d)
e)
Jr. Residents
f)
D.
TEACHING HOSPITAL
1)
Number of
Teaching Beds
Number of Units
Number of beds
Unitwise
per unit
staff
composition
With names
Qualification
& Designation
of staff
____________________________________________________________________________________________________________
Pediatrics
2).
3)
Indoor admissions
a.
Annual admissions
b.

INTENSIVE CARE
No. of beds
a)
Pediatric Intensive Care Unit (I.C.U.)
b)
Intensive Care (Nursery)
Temperature
Controlled
Yes/No
4)
5)
OUT-PATIENT DEPARTMENT :
a)
b)
Is outpatient service Department wise
d)
Arrangement for clinical

Instructions to student in
General Medicine & Allied specialties
d)
1.
Old Patients
2.
New Patients
3.
Total
6)
CLINICS
:
Frequency
Per
Week
__________________________________________
1.
Well Baby/Child Welfare Clinic
2.
Immunization Clinic
3.
Child Guidance Clinic
4.
Child Rehabilitation Clinic including

Facilities for speech therapy
and occupational therapy.
5.
Any other clinic
Are U.G.
students
posted in
these
Clinics
7)
NEW BORN NURSERY :
i)
No. of beds
ii)
Does it have facilities for temperature

and humidity control?
iii)
Staff posted
Medical
Staff Nurses
iv)
Equipment available
(v)
Are the undergraduate students posted in delivery room?
If yes, who supervises their training for neonatal resuscitation?

a)
Deptt. of Obst. & Gynae. Faculty
b)
Faculty of Pediatrics
c)
Any other
8)
TEACHING AND TRAINING FACILITIES :
A.
In OPD
B.
a)
b)
Number of rooms in the OPD for

seeing the Patients by various
faculty members and Resident staff :
In-door
a)
Bedside teaching
b)
Clinical demonstration room/seminar room
D.
Teaching Programme :
1.
with
Head
of
the
department).
Curriculum in the subject of Paediatrics
including Neonatology as prescribed by
MCI (a copy of the detailed curriculum
along
with
the
departmental
and

be appended).

totality?

reasons thereof?

of India.

II. Methodology
Number
1)
Total duration of Clinical Postings
2)
Didactic Lectures
3)
Demonstrations
4)
Tutorials
5)

6)
Practicals
7)
Bedside Clinics
8)
How many hours does a student

spend daily at the wards for clerkship
9)
Average Number of students posted at a

time for indoor OPD postings :
10)
Do students write case histories in a

prescribed book.
11)
Are they corrected?
12)
If so, by whom?
13)
Is the clinical work done in the wards by

the students assessed periodically?
14)
If so, how often and by whom?
15)
Total period of attendance in OPD by a

student throughout clinical training.
16)
Is it done concurrently with the inpatients

ward postings?
17)
Who gives them training to attend to

causalities?
18)
How is the outpatients teaching organized?
19)
Do students attend clinico-pathological conferences?
20)
If so, on an average, how often during the

whole period of pediatrics postings?
21)
Any other teaching/training activities :
22)

If yes, details thereof :
23)
Records : Methods of Assessment thereof :
24)
Internship training programme

a)
b)
Method of assessment of internship

(Please attach a copy of log
book/assessment sheet).
Time
table
of
lectures,
demonstrations, seminars, tutorials,
practical, OPD and indoor postings
etc. may be given.)
E.
(SIF B-11)

FORM B
On the
SURGERY
(INCLUDING GENERAL SURGERY, ORTHOPAEDICS, OTO-RHINOLARYNGOLOGY, OPHTHALMOLOGY, RADIO-DIAGNOSIS, RADIO-THERAPY,
ANAESTHESIOLOGY, PHYSICAL MEDICINE & REHABILITATION AND
DENTISTRY
Name of Institution ............

Place ...............

(with seal)
Signature of the

such additional information as may be necessary to fill-in the spaces
1.
2.
3.
4.

Visitation
A1 : Department of General Surgery (Including Pediatric Surgery)
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
Any other
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Category
(cont.)
Post
Experience
Professor
Associate
Professor/Read
er
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remarks
if any,
As Professor
Institution
19
From
20
To
21
Total
22
23
24
Jr. Resident
Any other
Category
A2 : Department of Orthopedics
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
Any other
category
(cont.)
Post
Experience
Professor
Associate
Professor/
Reader
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remarks
if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
Any other
Category
A3 : Department of Ophthalmology
Post
No.
Name

Date
1
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
(cont.)
Post
Experience
Grand
Total
of
Teaching
Experience
As Professor
Remarks
if any,
Institution
From
15
16
To
17
Total
18
Institution
19
From
20
To
21
Total
22
23
24
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
A4 : Department of Oto-Rhino-Laryngology
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
(cont.)
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Post
Experience
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remarks if
any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
A5 : Department of Radio-diagnosis
Post
No.
Name

Date
1
Professor
Associate
Professor/Rea
der
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Jr. Resident
Any other
Category
(cont.)
Post
Experience
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Resident
Jr. Resident
Any other
category
A6 : Department of Radio-therapy
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
(cont.)
Post
Experience
Grand
Total
of
Teaching
Experience
As Professor
Remark
s if any,
Institution
From
15
16
To
17
Total
18
Institution
19
From
To
20
21
Total
22
23
24
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
A7 : Department of Anesthesiology
Post
No.
Name

Date
1
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Jr. Resident
Any other
Category
(cont.)
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt From To Total
.
11
12
13
14
Post
Experience
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
A8 : Department of Physical Medicine & Rehabilitation
Post
No.
Name

Date
1
Professor
Associate
Professor/Rea
der
Asst. prof.
/Lecturer
Registrar/Sr.
Resident
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt. From
To Total
11
12
13
14
Jr. Resident
Any other
Category
(cont.)
Post
Experience
Professor
Associate
Professor/
Reader
Asst. prof.
/Lecturer
Registrar/Sr.
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Resident
Jr. Resident
Any other
category
A9 : Department of Dentistry
Post
No.
Name

Date
1
College
5
Univ.
6
Experience
As Sr.
Resident/Registrar
Total
Instt. From
To
7
10
As Asst.
Professor/Lecturer
Instt. From
To Total
11
12
13
14
Professor
Associate
Professor/Rea
der
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
(cont.)
Post
Experience
Grand
Total
of
Teaching
Experience
As Professor
Remark
s if any,
Institution
From
15
16
To
Total
17
Professor
Associate
Professor/
Reader
Asst. prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
category
B.
18
Institution
19
From
20
To
21
Total
22
23
24
Nomenclature
Names of staff members

General Surgery
Technical
Assistant
Technician
Lab Attendant
Reception
Orthopedics
Oto-RhinoLaryngology
Ophthalmology
Nomenclature

General Surgery
Steno-typist
Record Clerk
Audiometry
Technician
Speech therapist
Orthopedics
Oto-RhinoLaryngology
Ophthalmology
Retractions
Any other category
Nomenclature

Radio-Diagnosis
Radiographic
Technician
Dark Room Asst.
Stenographer
Radio-Therapy
Anaesth.
Phy. Med. & Rehab.
Dentistry
Steno-typist
Storekeeper
Storekeeper-cumclerks
Nomenclature

Radio-Diagnosis
Record Clerk
Radio-Therapy
Anaesth.
Phy. Med. & Rehab.
Dentistry
Radiotherapy
Technician
Physio-therapist
Occupational
therapist
Speech Therapist
Prosthetic and
orthodox
Technician
Workshop workers
Clinical
Psychologist
Nomenclature

Radio-Diagnosis
Medio-Social worker
Radio-Therapy
Anaesth.
Phy. Med. & Rehab.
Dentistry
Public Health
Nurse/Rehabilitation
Nurse
Vocational Counsellor
Multi-rehabilitation
worker
(MRW)/Technician/th
erapist
Class IV workers
Dental Technicians
Tech. Asst.
Technicians
Any other category
C.
BUILDINGS :
Gen.
Surgery
OtoOphth.
Radio
RhinoDiag.
Laryngology
____________________________________________________________________________________________________________
(i) Clinical Demonstration
Room
a)
Number
b)
Accommodation (of
each demonstration
Theatre)
c)
i)
Size
ii)
Capacity
Audio-visual equipment
available.
Ortho.
Gen.
Surgery
(ii)
Departmental Library-cum-Seminar Room
a)
b)
Accommodation
c)
Size
Capacity
Ortho.
OtoOphth.
RhinoLaryngology
Number of Books in Physiology including Biophysics
Radio
Diag.
d)
List of Journals
GENERAL SURGERY AND ALLIED SPECIALITIES
(iii)
Research Laboratory
a)
Size
b)
Equipment
c)
Are there any students taken for M.S. or M.Sc. or Ph.D

in Anatomy?
If so how many per year during the last three years?
vii
1)
Diploma
2)
Degree
viii
d) List of publications by the members of the staff during
the last 3 years?
GENERAL SURGERY AND ALLIED SPECIALITIES
e)
Current problems on which research work is going on and by whom?

f)
Do Undergraduate students in any way participate in them ?
Gen.
Surgery
(IV)
a)
Professor and HOD
b)
c)
d)
Ortho.
OtoOphth.
RhinoLaryngology
Radio
Diag.
C.
1)
e)
Jr. Residents
e)
TEACHING HOSPITAL
Number of
Teaching Beds
Number of Units
Number of beds
Unitwise
staff
composition
With names
Qualification
& Designation
of staff
____________________________________________________________________________________________________________
Surgery and allied specialities :
a)
General Surgery
including Paediatric Surgery
A separate sheet
may be attached
b)
Orthopaedics
----do----
c)
Oto-Rhino-Laryagology
----do----
d)
Ophthalmology
----do----
Gen.
Surgery
2.
Indoor admissions
a)
Annual admissions
Ortho.
OtoOphth.
RhinoLaryngology
Radio
Diag.
b.
3)

INTENSIVE CARE
Is there any Intensive Care Unit
For surgery and allied specialties :
If yes, please indicate a number of
Beds and equipments available
for each specialty.
Names of speciality
No. of beds
4)
Names of equipment
a)
General Surgery
b)
Orthopedics
c)
Oto-Rhino-Laryngology
d)
Ophthalmology
Names of equipments
e)
Radio-diagnosis
f)
Radio-therapy
g)
Anesthesiology
h)
Physical Medicine &

Rehabilitation
i)
Dentistry
5)
Outpatient Department :
a)
b)
Is out patient service department wise
c)
Arrangement for clinical Instructions to

student in General Surgery & Allied specialties
d)

General
Surgery
OtoOphth
RhinoLaryngology
____________________________________________________________
1.
Old Patients
2.
New Patients
Ortho.
3.
6)
Total
Teaching and training facilities :
General
Surgery
OtoOphth
RhinoLaryngology
____________________________________________________________
A.
B.
In O.P.D.
a)
b)
Number of rooms in the OPD

and resident staff
In-door
a)
Bedside teaching
Ortho.
b)
Clinical demonstration room/

seminar room
7)
FACILITIES AVALIABLE IN OUT-PATIENT DEPARTMENT :
1.
In Surgery and allied speciality
2.
a)
Dressing room for men
b)
Dressing room for women
c)
Operation theatres
For out patient surgery
In Orthopedics
a)
Plaster room
b)
Plaster cutting room
c)
Outpatient X-ray facilities
Yes
No
3.
4.
In Oto-Rhino-Laryngology
a)
Sound proof air-conditioned

audiometery room
b)
ENG Laboratory
c)
Speech therapy facilities
In Ophthalmology
a)
Refraction room
b)
Dark room
c)
Dressing room
8.
OPERATION THEATRE UNIT :
(1)
Operation theatres
(a)
Number
(b)
Arrangement & Distribution
(c)
Equipment :
(including Anesthesia equipment)
(d)
Facilities available in each O.T. unit Present/Absent

(i)
Waiting room for patients
(ii)
Soiled Linen room
(iii)
Sterilization room
(iv)
nurses duty room
(v)
Surgeons & Anesthetists room
For Males
For Females
(vi)
Assistants room
(vii)
Observation gallery for students
(viii) Store room
(2)
(ix)
Washing room for surgeons & Assistants
(x)
Students washing up and dressing up room
Arrangement of Anesthesia
(a)
Pre-anaesthetic care
(b)
Nature of anesthesia used :
(c)
Post-anaesthetic care
Pre-operative ward (no. of beds)
Post-operative ward (no. of beds)
Resuscitation facilities and special equipment :
If any super specialty exists

Give details
9)
Number of surgeries performed during the last one year.
Names of the department
Major
a)
General Surgery including Pediatric Surgery
b)
Vasectomies performed
c)
Orthopaedics
d)
e)
Ophthalmology
E)
TEACHING PROGRAMME

1.
(To be filled by the Dean/Principal along with Head of the department).
Curriculum in the subject of Gen. Surgery. Ortho., Oto-Rhino-Laryngology,
Ophth., Radio-diag., Anaes. & Dentistry as prescribed by MCI (a copy of the
detailed curriculum along with the departmental and educational objectives of
the subject may be appended).
Minor
Is the above curriculum followed in totality?

(To be filled in by the Inspectors/Visitors). Does the curriculum of

studies adopted by the training center differ materially from that recommended
by the Medical Council of India.
If so what are the variations and what are your observations regarding them ?
III.
Methodology
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
___________________________________________________________________________________
1)
Total
of clinical postings
2)
Didactic Lecturers
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
___________________________________________________________________________________
3)
Demonstrations
4)
Tutorials
5)

6)
Practicals
7)
Duration of operation theatre postings.
8)
Bedside Clinics.
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
9)
___________________________________________________________________________________
How many hours does a student
spend daily at the wards for clerkship
10)
Average Number of students posted at a time for indoor OPD postings :
11)
Do students write case histories in a prescribed book.
12)
Are they corrected?
13)
If so, by whom?
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
___________________________________________________________________________________
14)
Is the clinical work done

In the wards by the
Students assessed
Periodically?
15)
If so, how often and by

whom?
16)
Total period of attendance

in OPD by a student
throughout clinical
training.
17) Is it done concurrently with

The inpatients ward postings?
18) Who gives them training to

attend to casualties?
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
___________________________________________________________________________________
19)
How is the outpatients teaching organized?
20)
21)
If so, on an average, how often during the whole period of pediatrics postings?
22)
Number
___________________________________________________________________________________
General
Surgery
Ortho.
Surgery
Oto-
Ophth
Radio
RhinoLaryngology
Anaes.
Dentistry
___________________________________________________________________________________
23)

If yes,
24)
(Time table of lectures, demonstrations, seminars, tutorials, practical and dissection may be given).
25)
Number
__________________________________________________________________________________
General
Ortho.
OtoOpath.
Phy.
Surgery
Surgery
RhinoMed.
Laryngology
&
Reh.
___________________________________________________________________________________
a.
b.
Method of Assessment for Internship

(Please attach a copy of logbook/assessment sheet).
General Surgery
Ophthalmology
Radio-Diag.
Radio-therapy
Anaesthesiology
Physical Medicine & Rehabilitation
Dentistry
F.
(SIF B-12)

FORM B
On the
OBSTETRICS AND GYNAECOLOGY
Name of Institution ............

Place ...............

department
Signature of the (with seal)

Head of the

such additional information as may be necessary to fill-in the spaces
1.
2.
3.
4.

Visitation
Department of Obstetrics and Gynecology
Post
No.
Name

Experience
As Res./Registrar
Date
1
Professor
Associate
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/Sr.
Resident
Jr. Resident
Any other
Category
College
5
Univ.
6
Instt.
From
To
Total
10
As Asst.
Professor/Lecturer
Instt. From
To Total
11
12
13
14
(cont.)
Post
Experience
Professor
Associate/
Professor/
Reader
Asst. Prof.
/Lecturer
Registrar/
Sr. Resident
Institution
From
15
16
To
17
Total
18
Grand
Total
of
Teaching
Experience
Remark
s if any,
23
24
As Professor
Institution
19
From
20
To
21
Total
22
Jr. Resident
Any other
category
Nomenclature
a. Antenatal Medical Officercum-lecturer/Asstt.

Professor
b. Maternity and Child Welfare

Officer cum- Lecturer/Asst.
Professor
c. Social Worker
d. Technical Assistant
Nomenclature
e. Technician
f. Lab Attendants
g. Stenographer
h. Record Clerk
i. Store Keeper
j. Any other Category
C.
Buildings :
(i)
Clinical Demonstration Room :
a)
Number
b)
Accommodation (of each demonstration room)
c)
(ii)
i)
Size
iii)
Capacity
Audio-Visual equipment available.
Departmental Library cum- Seminar Room :
a)
b)
Is there a separate departmental

library?
Accommodation
i)
Size
ii)
Capacity
c)
Number of books in Obstetrics &

Gynecology and allied subjects
d)
List of Journals
(iii)
Research Laboratory
a)
Size
b)
Equipment
c)
Are there any students taken for M.S. or

M.Sc. or Ph.D in Anatomy?
If so how many per year during the last
three years?
d)
1)
Diploma
2)
Degree
List of publications by the members of the

staff during the last 3 years?
e)
Current problems on which research work

is going on and by whom? (a statement
may be furnished)
f)
Do Undergraduate students in any way

participate in them ?
(iv)
a)
Professor and HOD
b)
c)
d)
Registrars/Sr. Residents
e)
Jr. Residents
f)
D.
1)
TEACHING HOSPITAL
Number of
Teaching Beds
Number of Units
Number of beds
Unitwise
staff
composition
With names
Qualification
& Designation
of staff
____________________________________________________________________________________________________________
OBSTETRICS AND GYNAECOLOGY
AND ALLIED SPECIALITIES :
a)
Obstetrics
b)
Gynaecology
A separate sheet
may be attached
----do----
c)
Postmartum
2.
Indoor admissions
----do----
General
TB & RD
DVD
Psychiatry
_______________________________________________________________________
a.
b.
Annual admissions
3)
INTENSIVE CARE
Is there any Intensive Care Unit
For Obst. & Gynae.
If yes, please indicate number
of beds and equipments available :
No. of beds
4)
c)
d)
Nursery
a)
No. of cots
b)
No. of beds
c)
Does it have facilities for

temperature and humidity
control.
Staff posted
Medical
Staff Nurses
Equipment available
5)
6)
Outpatient Department :
a)
b)
Is out patient service department wise
Names of equipment
c)
Arrangement for clinical Instructions to

student in General Surgery & Allied specialties
d)
1.
Old Patients
2.
New Patients
3.
Total
7) Teaching and training facilities :
A.
In O.P.D.
a) Clinical demonstration room :
b) Number of rooms in the OPD

and resident staff
B.
In-door
a) Bedside teaching
b) Clinical demonstration room/

seminar room
8)
FACILITIES AVALIABLE IN OUT-PATIENT DEPARTMENT :
1.
9.
In Obst. & Gynae. and allied speciality

a)
Antenatal Clinic
Frequency and run by whom
b)
Family Welfare Clinic

Frequency and run by whom
c)
Postnatal Clinic
frequency and run by whom
d)
Sterility Clinic
e)
Cancer Detection Clinic

f)
Are the Medical Students

posted in these clinics?
OPERATION THEATRE (with Obst. & Gynae. Deptt.)

(a)
Number
(b)
Size & design
Yes
No
(a)
Equipment
d)
Lightning arrangement,
air-conditioning etc.
e)
Arrangement for students

to watch operations.
f)
Anaesthetic room
g)
Preparation room
h)
Sterilizing room
i)
Recovery room
j)
Postoperative wards
k)
Resuscitation & blood

Transfusion service
l)
Any other remarks.
10)
Labour Room :
Number
a)
Clean
b)
Septic
c)
Number of beds in each
d)
Arrangement of lights &

for operative interference
e)
Arrangement for Sterilization
f)
Preparation room
g)
Waiting wards
h)
Anaesthesia staff &

facilities for administration
Of anaesthesia
i)
Baby room
11)
POSTMARTUM UNIT
a)
b)
Is there a postmortem
unit attached to the department ?
Yes
No
If yes, staff under the postmortem unit.

Name
1.
Medical
2.
Non-Medical
c)
Number of beds
Designation
Qualification
d)
Population attached with

the postmortem unit
e)
Number of eligible couples in

population attached with the
postmortem unit.
f)
Couple protection rate in the

Population attached with the
Population unit.
12.
OPERATIONS & LABOURS FOR THE LAST ONE YEAR :

a)
Gynecological Operations
Major
Minor
b)
Total number of labours
c)
Abnormal labours
d)
Antenatal cases seen in OPD
e)
Total number of sterilizations
1)
Tubectomies
2)
Medical Termination of Pregnancies (MTP)
D.
TEACHING PROGRAMME

I.
with
Head
of
the
department).
Curriculum in the subjects of Obst. &
Gynae. as prescribed by MCI (a copy of
the detailed curriculum along with the
departmental and educational objectives
of the subject may be appended).

totality?

reasons thereof?
(To
be
filled
in
by
the
Inspectors/Visitors). Does the curriculum of
studies adopted by the training center differ
materially from that recommended by the
Medical Council of India.
If so what are the variations and what

are your observations regarding them ?
II. Methodology
Number
1)
Total duration of clinical postings
2)
Didactic Lectures
3)
Demonstrations
4)
Tutorials
5)

6)
Practicals
7)
Duration of operation theatre postings
8) Duration of labour postings and the number

of cases observed/conducted by a student
9)
Bedside Clinics
10)
How many hours does a student spend

Daily in the wards for clerkship.
11)
Average number of students

Posted at a time for indoor/OPD postings
12)
Do students write case histories &

Delivery notes in a prescribed book.
13)
Are they corrected?
14)
If so, by whom?
15)
Is the clinical work done in the wards

by the students assessed periodically?
16)
If so, how often and by whom?
17)
Total period of attendance in OPD by a

a student throughout clinical training
18)
Is it done concurrently with the inpatients

Wards postings?
19)
Who gives them training to attend to casualties?
20)
How is the outpatient teaching organised?
21)
22)
If so, on an average how often during
the whole period of Obst. & Gynae. Postings?
23)
24)

If yes, details thereof :
25)
Records : Methods of Assessment thereof?
(Time table of lectures, demonstrations, seminars,

practical, OPD and indoor postings etc. may be given)
26)
a)
b)
Method of assessment of Internship

(please attach a copy of log book
assessment sheet).
tutorials,
E.
Observations of the Inspectors/Visitors :

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(SIF B-1)

MEDICAL COUNCIL OF INDIA

RVS INSTITUTION OF MEDICAL SCIENCES

R.V.S. Nagar, Tirupathi Road,

Affiliated to the University of : DR.NTR UNIVERSITY OF HEALTH

Signature of the Dean/Principal

(This form shall be first filled in by the Principal/Dean of the college in

Date of Inspection/ Visitation

Date of last Inspection/

Defects pointed out in the last

To what extent remedied

Qualification with dates

B. List of non-teaching staff :

Name(s) of staff members

Dissection Hall Attendants

Store Keeper cum clerk

Any other category

C. Give the various sub-section in the Department, if any, like Gross

Is the teaching staff rotated in these sections and if so up to what

c) Audio-visual equipment available.

Departmental Library-cum-Seminar Room :

Is there a separate departmental library?

Number of books in Anatomy and allied subjects

Number and arrangement of tables

Hygiene and Drainage facilities for Disposal of

No. of wash basins provided

No. of lockers provided for students :

Light and exhaust arrangements

Special Instruments other than routine Dissection sets, such

Extra Learning Aids provided in the Dissection Hall

Cadaver Preservation Facilities

No. of Cadavers available

No. of students allotted per cadaver

Cupboard for storage of microscope slides etc.

Number of Microscopes with 1/3, 1/6, & 1/12 objectives

Number of students to each Microscope

Whether Laboratory Manuals kept by students?

Are there any students taken for M.S. or M.Sc. or Ph.D in

If so how many per year during the last three years?

List of publications by the members of the staff during the last 3

Current problems on which research work is going on and by

Do Undergraduate students in any way participate in them ?

How are the specimens arranged?

Give Number of each

Coverage of various fields in Anatomy by Specimens

No. of catalogues of the specimens available to the students.

Specimens in Embroyology, Neuro-Anatomy, Histology, Gross

Display of Microscopic sections of normal developing tissues

Are the microscopic sections of the specimens available for study to

Number of Microscope & X-ray view Boxes available to students in

List of exhibits other than the specimens and their arrangement.

Radiological & specialized imaging exhibits:

Charts, Skeletons etc.

Seating arrangement for students

Preparation and storage rooms

Professor and HOD

Non-teaching and clerical staff:

(For duration of the entire course)

Is the above curriculum followed in

If not, what are the variations and

(To be filled in by the Inspectors/Visitors).

If so what are the variations and what are

Seminars conducted during the year